Medical Leaders Speak Up for Trans Health
Over 20,000 of you helped us fight against the Trump administration by submitting comments at ProtectTransHealth.org. Transgender people and our allies, families, friends, partners, educators, and medical providers spoke up against a proposal from the administration to rollback the Health Care Rights Law, a crucial protection for trans people denied the same medical treatment and insurance coverage as anyone else.
With the August 13th deadline passed, the Department of Health and Human Services is steadily making many of these comments available to the public. While the tens of thousands of voices resisting the Trump administration can help us make a huge impact, the voices of major medical leaders and organizations have joined yours in demanding HHS protect health care access for 2 million transgender Americans. Just some of these organizations include:
As advocates for our patients, we strongly support patients’ access to comprehensive health care services. Physicians are expected to provide care in emergencies, respect basic civil liberties, and not discriminate against individuals in deciding whether to enter into a professional relationship with a new patient. We expect the same for the rest of the health care system and for the federal government’s health care activities and programs. In sum, the AMA strongly opposes the proposed elimination or rollback of critical protections guaranteed by section 1557 of the ACA and the Current Rule and, accordingly, we urge HHS to withdraw this proposal.
The proposed rule does not align with APA values. According to the APA ethics code, patient welfare should be at the forefront in all health care settings.43 The rights of patients must be paramount. Our guidelines for serving a diverse public affirm that “psychologists need to interact beneficially and non-injuriously with all clients/patients who seek care. When such conflicts occur, the overriding consideration must always be the welfare of the client/patient.”44 We firmly believe that these principles – placing patient welfare front and center – should hold true across health care settings.
The AAP and SAHM strongly oppose the proposed rule, which would severely threaten access to care for millions of children and adolescents, including those that identify as LGBTQ, those with limited English proficiency, and those who have sought or may seek comprehensive reproductive health services. Despite civil rights protections established in statute, the proposed rule could have grave consequences through the limited definitions of discrimination, the narrowing of covered entities, and the changes to enforcement. As such, we urge the Department to rescind the proposed rule in its entirety and leave the 2016 final rule in place.
Patients deserve affordable, quality health care regardless of race, color, national origin, sex, gender identity, sexual orientation, age, or disability. AHIP’s members – which together serve hundreds of millions of Americans – believe everyone should be able to get the coverage and care they need without fear of discrimination. Removing references in the rule to discrimination based on gender identity, sex stereotyping, and pregnancy status is inconsistent with providing access to affordable high-quality care to everyone. Those changes should not be finalized.
Every year our members, the P&As receive calls for help from individuals who have been denied access to medically necessary services. Section 1557 and its implementing rules are a critical tool to fight this discrimination on the basis of disability. HHS underwent a comprehensive public process to develop the Section 1557 regulations, including a request for Information, proposed rule, and final rule. HHS considered more than 24,875 public comments submitted for the 2016 rule. There is no reason to reopen this rule and ignore the reasoned process HHS has already undertaken.
ANA believes this new rulemaking is misguided and irresponsible, and is out of step with the values of the nursing profession. We believe the proposal should be rescinded entirely so that the existing Section 1557 regulations remain available to protect access to health care for all patients.
The regulations regarding Section 1557 specifically adds new protections for women, members of the LGBTQ population, and limited English proficient individuals. By amending Section 1557 regulations to reflect a more limited set of regulatory language, HHS would in effect eliminate these protections needed by vulnerable patient populations, including patients identifying as trans, that have historically been disregarded and discriminated against in health care programs. As future physicians, AMSA does not 2 believe that sacrificing needed protections for vulnerable patient populations is an acceptable cost for keeping the regulatory burden consistent across the Executive Branch.
American Osteopathic Association
This change permits discrimination against an already vulnerable population. Transgender patients have been found to frequently delay or forgo care due to fears of discrimination, and these delays in care have been linked to poor health outcomes. As physicians, we are deeply concerned about the consequences that eliminating non-discrimination provisions will have on members of the transgender community.
Section 1557 of the ACA was designed specifically to prohibit discrimination, help close health disparities, and advance health equity. Yet, the proposed rule would do exactly the opposite, severely undermining access to care, weakening existing patient protections, enabling discrimination, and undermining civil rights protections. The AHA is deeply concerned that the proposed rule would harm the health and wellbeing of millions of patients and their families by eroding health care access and gains in insurance coverage and health disparities made under the ACA.